A Preoperative Design Combining With Aesthetics Of Eyes To Address Mild And Moderate Dermatochalasis In Upper Blepharoplasty

Objective:The preoperative design of upper blepharoplasty are key factors for creating a satisfactory appearance and cosmetically pleasing supratarsal crease,especially for patients with mild to moderate upper eyelid skin laxity.We aimed to propose a preoperative invaginating-simulating design method combining aesthetic criteria of eyes to determine the amount of skin removal and correct mild to moderate upper eyelid laxity,and eventually create a natural and attractive supratarsal fold.Methods:We retrospectively analyzed the clinical data of all patients with mild to moderate dermatochalasis who underwent pre-operative design and upper blepharoplasty in the Department of Plastic and Cosmetic Surgery of the Nanchang University Second Affiliated Hospital from September 2018 to December 2021.Three points(Points A,B,and C)and three lines(Lines A,B,and C)were marked on the upper eyelid by preoperative invaginating-simulating design method,and blepharoplasty was performed according to the preoperative evaluation.Postoperative outcomes were evaluated by using the Strasser grading system and the Global Aesthetic Improvement Scale(GAIS),and patients’ satisfaction was followed.Results:A total of 142 patients were included in this study and followed up for at least 6months after surgery.The “optimal incision” of skin removal was knife-shaped.The mean score of Strasser grading was 2.2±3.32 points,and the result showed that 130 of142 patients(91.5%)were considered “excellent” and 12 of 142 patients(8.5%)were considered “moderate”.The results of GAIS showed 127 patients(89.4%)were judged as “very much improved”,11 patients(7.8%)were judged as “much improved”,and 4 patients(2.8%)were judged as “improved”.The patients’ satisfaction rates regarding the improvement of redundant skin and eye aesthetics were 90.1% and 92.3% respectively.No severe complications such as infection,eyelid retraction,or ptosis were observed.Conclusions:Our preoperative invaginating-simulating design method determines the amount of excision skin and forms a skin incision by simulating the expected morphology of the double eyelid and combined with the esthetics of eyes,which can effectively correct dermatochalasis and achieve beautiful and natural double eyelids.